A brief for awareness and safety measure to stay safe from coronaviruses.

1. Corona-Virus Disease 2019
CoViD-19
DR. AMANDEEP BIJRAL
SENIOR MEDICAL
OFFICER
AMANDEEP GROUP
Domain: Viruses
Family: Coronaviridae
Sub-Family: Orthocoronavirinae
Order: Nidovarales
Phylum: Ribiviria
Genus: Alphacoronavirus

2. CoViD-19 Awareness, need of time
 The fight against rumors and misinformation is a vital component of battle against the viruses.
 Epidemic of CoViD-19 is a continuous threat for each an every nation whether poor or small and
developed or developing.
 Most of us are afraid, which is acceptable But it can be moderated by accurate knowledge.
 We all are responsible for reducing the risks of getting and/or spreading infections.
 Out of all the cases reported in 33 countries, 80 recent of cases were from three countries.
 As of 7th March 2020, there have been at least 3,600 confirmed deaths and more than 106,482
confirmed cases in the coronavirus pneumonia outbreak.
 Around 60,366 cases have been recovered .

3. HISTORY OF CORONAVIRUS
 Coronaviruses belongs to family of Coronaviridae which consists of about 40 different species,
which cause infections to humans, chickens and animals such as camels, bats wild cats etc.
 CoViD-19 is the third disease caused by coronaviruses. First was SARS in 2003 in Asian region and
second was MERS in 2012 in Saudi Arabia
 SARS-Severe Acute Respiratory Syndrome in 2003
 MERS-Middle East Respiratory Syndrome in 2012
 Coronaviruses are believed to cause 15 to 30% of all common colds in adults and children.
 The size of coronavirus is largest of all known RNA- viruses.

4. STRUCTURE OF CORONAVIRUSES
 The name coronavirus is derived from the Latin word
corona which means crown, referring to the
characteristic appearance reminiscent of a crown
around the virions (virus particles) when viewed under
2-D electron microscope.
 They are enveloped viruses with a positive-sense-
single stranded RNA genome with nucleocapsid of
helical symmetry.

5. CHEMICAL STRUCTURE
 The morphology of coronavirus is:
 Proteins that contribute to the overall structure
of all coronaviruses are the spike (S), envelope
(E), membrane (M), and nucleocapsid (N).
 In the specific case of the coronavirus (see
figure), a defined receptor-binding domain on S
mediates the attachment of the virus to its
cellular receptor,ACE2.
 Some coronaviruses also have a shorter spike-
like protein called hemagglutinin esterase (HE)
 The coronavirus RNA genome has methylated
cap at 5 end and polyadenylated tail at 3 end,
which allows the RNA to attach to the host
cell's ribosomes for translation

6. Mode of spread of Infection
 While animals are the original source of
the virus, it is now spreading from person
to person (human-human transmission).
 The virus seems to be transmitted via
respiratory droplets that people sneeze,
cough, or exhale.
 The virus can also survive for several
hours on surfaces such as tables and
door handles.
 The incubation period for COVID-19 is
currently estimated at between 2
to14 days.

7. SYMPTOMS
 Coronavirus mainly affect the respiratory system in the human beings and rarely to gastro-
intestinal tract.
 Pre-existing illnesses that put patients at higher risk include cardiovascular disease, diabetes,
chronic respiratory disease and hypertension.
 Reported illnesses have ranged from mild symptoms to moderate symptoms.
 More serious cases develop severe pneumonia, acute respiratory distress syndrome, sepsis and
septic shock that can lead to death.

8. SYMPTOMS INCLUDE:
 Mild Symptoms:
 Fever
 Cough
 Dyspnea
 Myalgia/ Fatigue
 Other symptoms:
 Sputum production
 Headache
 Hemoptysis
 Sore throat
 Runny Nose
 Chest pain
►Gastro-intestinal Symptoms [Rare]:
►Diarrhea
►Nausea
►Vomiting

9. SIGNS ANS SYM P TOMS

10. TREATMENT AND VACCINATION
 There is no specific treatment for this disease, so healthcare providers treat the clinical
symptoms (e.g. fever, difficulty breathing) of patients. Supportive care (e.g. fluid management,
oxygen therapy, etc.) can be highly effective for patients with symptoms.
 There are currently no vaccines against human coronaviruses, including the virus that causes
COVID-19.
 This is why it is very important to prevent infection and to contain further spread of the virus.

11. PREVENTIVE MEASURES
 When someone coughs or sneezes, a small amount of liquid droplets containing virus are omitted
from their nose or mouth which contaminate the surroundings and may spread to healthy person
if barrier precautions are not taken.
 Preventive measures are need for protection, which is of 2 types:
 SELF-Protection:
 To avoid getting infections from others who are ill/infected.
 MASS Protection:
 To avoid spreading infections to others when you are ill/infected.

12. PREACUTIONS FOR SELF
PROTECTION
 Avoid close contact with people who are sick.
 Avoid touching your eyes, nose, and mouth frequently.
 Cover your face while coughing or sneezing with a tissue, then throw the tissue in the trash.
 Clean and disinfect frequently touched objects and surfaces using a regular household cleaning
spray or wipe.
 Change your face mask daily.
 Frequently wash your hands with soap and water for at least 20 seconds or, if soap and water are
not available, clean your hands with an alcohol-based hand sanitizer that contains at least 60%
alcohol.

13. PRECAUTIONS FOR MASS
PROTECTION
 People who are mildly ill with COVID-19 are able to isolate at home during their illness.
 You should restrict activities outside your home, except for getting medical care. If you have a medical
appointment, call the healthcare provider and tell them that you have or may have COVID-19. This will help the
healthcare provider’s office take steps to keep other people from getting infected or exposed.
 Do not go to work, school, or public areas.
 You should wear a facemask when you are around other people (e.g., sharing a room or vehicle) or pets and
before you enter a healthcare provider’s office. If you are not able to wear a facemask (for example, because it
causes trouble breathing), then people who live with you should not stay in the same room with you, or they
should wear a facemask if they enter your room.
 Cover your mouth and nose with a tissue when you cough or sneeze. Throw used tissues in a lined trash can.
Immediately wash your hands with soap and water for at least 20 seconds or, if soap and water are not
available, clean your hands with an alcohol-based hand sanitizer that contains at least 60% alcohol.

14. PRECAUTIONS FOR MASS
PROTECTION
 Soap and water are the best option if hands are visibly dirty. Avoid touching your eyes, nose, and mouth with
unwashed hands.
 You should not share dishes, drinking glasses, cups, eating utensils, towels, or bedding with other people or
pets in your home. After using these items, they should be washed thoroughly with soap and water.
 High touch surfaces include counters, tabletops, doorknobs, bathroom fixtures, toilets, phones, keyboards,
tablets, and bedside tables. Also, clean any surfaces that may have blood, stool, or body fluids on them. Use a
household cleaning spray or wipe, according to the label instructions. Labels contain instructions for safe and
effective use of the cleaning product including precautions you should take when applying the product, such
as wearing gloves and making sure you have good ventilation during use of the product.
 Patients with confirmed COVID-19 should remain under home isolation precautions until the risk of secondary
transmission to others is thought to be low. The decision to discontinue home isolation precautions should be
made on a case-by-case basis, in consultation with healthcare providers and state and local health
departments

15. HAND HYGEINE
 Practicing hand hygiene is a simple and effective way to
prevent infections.
 Hand Hygiene means cleaning your hands by:
 Handwashing:
 Washing hands with soap and water, when hands are
visible soiled and or before any aseptic procedure.
 Hand rub:
 Sanitizing the hand with alcohol-based hand sanitizer.

16. 5 MOMENTS OF HAND HYGEINE

17. GENERAL HAND HYGEINE MOMENTS
 Immediately before touching a suspected patient.
 After caring for a person with known or suspected infections.
 After touching the patient or the patient’s immediate environment.
 After contact with blood, body fluids or contaminated surfaces.
 Before performing an aseptic task (e.g., placing an indwelling device) or handling invasive medical
devices.
 Before moving from work on a soiled body site to a clean body site on the same patient.
 Immediately after gloves removal.

18. STEPS OF HAND HYGEINE
Perform each step
for 6 seconds each.

19. HAND WASHING
 Technique of Hand Washing
 Wet your hands first with water and pour the
soap [prefer liquid over soap-cakes].
 Rub your hands together vigorously following
steps of hand hygiene, covering all surfaces of
the hands and fingers.
 Rinse your hands with water and use
disposable towels to dry.
 Use towel to turn off the faucet.
 Avoid using hot water, to prevent drying or
burning of skin.

20. HAND RUB
 Technique of Hand Rub when not soiled):
 Apply the antiseptic hand rub (i.e. alcohol-
based hand sanitizer) on your hands.
 Cover all surfaces of hand following all the
steps of hand hygiene.
 Continue till hands feel dry

21. SURGICAL MASK
 A surgical mask, also known as a procedure
mask, medical mask or simply as a face mask,
 It is intended to be worn by health care professionals
during surgery and during nursing to catch the bacteria
shed in liquid droplets and aerosols from the wearer's
mouth and nose.
 Surgical masks protect wearers from being splashed in
the mouth with body fluids, and prevent transmission of
body fluids from the wearer to others, e.g. the patient.
 They also remind wearers not to touch their mouth or
nose, which could otherwise transfer viruses and
bacteria after having touched a contaminated surface .

22. SURGICAL MASK vs NIOSH MASKS
 Surgical masks are popularly worn by the general
public to reduce the chance of spreading air-borne
diseases and to prevent the breathing in of airborne
dust particles created by air pollution.
 A surgical mask is not to be confused with a
respirator and is not certified as such.
 Surgical masks are not designed to protect the wearer
from inhaling airborne bacteria or virus particles and
are less effective than respirations – N95, N99masks,
which provide better protection due to their material,
shape and tight seal designed for this purpose.

23. NIOSH MASKS
 NIOSH stands for National Institute for Occupational
Safety and Health.
 NIOSH has currently established nine classifications of
approved particulate filtering respirators based on a
combination of the respirator series and efficiency level.
 N for Not resistant to oil. Used when oil particulates are not present.
 R for Resistant to oil. Used when oil particulates are present and the
filter is disposed of after one shift.
 P for oil Proof. Used when oil particulates are present and the filter is
re-used for more than one shift.
 The digits 95,97,99 represents the efficiency level of filter.

24. Who need the mask?
 The masks are needed by 2 type of individuals:
 1. WHO is THE RISK- The person who is suspected or infected with coronavirus.
 2. WHO are AT THE RISK- The persons who are in contact with the person suspected or
infected with coronavirus.
 WITH IDENTIFIED THREAT- To healthcare professionals for consultants, doctors, nursing,
paramedics and general duty assistants handling these patients.
 WITH UNIDENTIFIED THREAT- To family members, co-passengers, persons working at airport,
railway stations and bus terminals and the persons going in large gatherings, movies, malls etc.

25. STIGMA AND RESILIENCE
 Public health emergencies, such as the outbreak of coronavirus disease 2019 (COVID-19), are
stressful times for people and communities.
 Fear and anxiety about a disease can lead to social stigma toward people, places, or things.
 Stigma can also occur after a person has been released from COVID-19 quarantine even though
they are not considered a risk for spreading the virus to others.
 Some groups of people who may be experiencing stigma because of COVID-19 include persons of
Asian descent, avid travelers, emergency responders or healthcare professionals
 Stigmatized groups may be subjected to Social avoidance or rejection, Physical violence and
denials of healthcare, education, housing or employment.
 Stigma hurts everyone by creating fear or anger towards other people.
 Everyone can help stop stigma related to COVID-19 by knowing the facts and sharing with others.

26. STEPS TO AVOID STIGMA
 Maintain privacy and confidentiality of those seeking healthcare and those who may be part of any
contact investigation.
 Quickly communicate the risk or lack of risk from associations with products, people, and places.
 Raise awareness about COVID-19 without increasing fear.
 Share accurate information about how the virus spreads.
 Speak out against negative behaviors, including negative statements on social media about groups of
people, or exclusion of people who pose no risk from regular activities.
 Be cautious about the images that are shared. Make sure they do not reinforce stereotypes.
 Engage with stigmatized groups in person and through media channels including news media and social
media.
 Share the need for social support for people who have returned from China or are worried about friends
or relatives in the affected region.

27. Let’s CARE and not SCARE
 Clean your hands frequently with sanitizer or soap and water.
 Health check-up regularly, if any of the symptoms occur.
 Isolate the infected person and use masks whenever applicable.
 Never touch your face and eyes with unclean hands.
 Avoid large crowds and social gatherings

28. Kindly ask, in case you have any queries….